In response to What is the role of tympanostomy tubes in the treatment of recurrent acute otitis media?

I appreciated the communication from Dr. Casselbrant et al. regarding the article titled “What Is the Role of Tympanostomy Tubes in the Treatment of Recurrent Acute Otitis Media?” This group has made many important contributions to our understanding of the pathophysiology and treatment of acute otitis media. Clarification of the findings in their study also helps to understand the importance of quality-of-life issues in children with acute otitis media, with and without tympanostomy tubes, and should be considered in light of treatment. I agree with the points made regarding antimicrobial prophylactic therapy with the potential development of antimicrobial resistance, and that the use of tympanostomy tubes is generally preferred over prophylaxis for recurrent acute otitis media. Continued randomized studies of children with recurrent acute otitis media will help further our understanding of this common pediatric condition.